6/20/2023 0 Comments Scleroderma face changes![]() People with limited scleroderma usually have Raynaud’s symptoms for years (often 5 to 10 years) before other signs of scleroderma are noted. Eventually, tissue loss occurs and the skin becomes more highly colored. In the more limited form, skin thickening is often restricted to the hands and face. With diffuse scleroderma, these areas of hardness are widespread and typically appear on both sides of the body. Later the skin becomes hard, shiny, and leathery. ![]() The puffiness is usually worse in the morning and reduces later in the day, especially in early stages of the disease. ![]() The first specific clinical symptom to suggest a diagnosis of scleroderma is skin thickening that begins as swelling or “puffiness” of the fingers and hands. However, in a small percentage of this population, the early appearance of Raynaud’s symptoms will be followed years later by ANA becoming positive and additional scleroderma symptoms developing over time. The clear majority of young women with Raynaud’s symptoms that appear in their teenage years never develop a positive ANA or any systemic damage or skin changes. This form of Raynaud’s is called “primary Raynaud’s.” A key distinguishing characteristic is that with primary Raynaud’s, the anti-nuclear antibody (ANA) will normally be negative, while with Raynaud’s which accompanies scleroderma or other auto-immune disorders (secondary Raynaud’s), ANA is usually positive. It is important to note, however, that Raynaud’s phenomenon without any underlying disease is not uncommon in the general population, especially among young women. Other early symptoms may be painful joints, morning stiffness, red swollen hands, fatigue, and/or weight loss. Raynaud’s phenomenon usually (but not always) precedes skin changes by several months with diffuse scleroderma and often precedes skin changes by several years with limited scleroderma. Scleroderma often begins with Raynaud’s phenomenon (see below) – the fingers and sometimes the toes lose circulation and turn white upon exposure to cold. No patient will experience all of these symptoms and, even among patients who have the same specific subtype of systemic scleroderma, there is a tremendous variability in terms of which symptoms ultimately will occur and in what order. This section includes a list of possible symptoms that can occur with different forms of systemic scleroderma.
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